LLLT Case Study

While this structure provides a starting point for the critique of evidence strength, the prudent evaluation and, subsequent, translation into practice guidelines requires further consideration (Greenhalgh, 2010). Research can be scrutinized into measures of quality. John Hopkins Hospital grades evidence on a high to low scale, A through C, based on criteria including consistency of results, reproducibility of findings, sample size of study, level of study control, organizational design, and expert opinion (Newhouse, Dearholt, Poe, Pugh, & White, 2005). Using this evaluation tool, an A score would result in a recommendation for clinical practice while a score of C should alert the clinician to a low quality of research and should not be incorporated into practice guidelines (Newhouse et al., 2005).

The author considers the simplest way of finding out best practice is by using guidelines. According to Field & Lohr (1992) guidelines are “systematic developed statements to assist practitioners and patients decisions for specific clinical circumstances.” Evidence is always current and a generous collection of many different systematic research reviews with multiple random control trials are available (AGREE, 2000). These types of trials are graded at the top level of hierarchy (Guyatt et al 2002).Nevertheless in contrast Devereaux and Yusuf (2005) argue that top level hierarchy is not a guaranteed deviation from the truth in randomized trials. The clinical guidance used is the National Institute of Clinical Guidance (NICE 2009) is based in the author’s homeland and is an independent organisation responsible for providing guidelines. The ethos behind NICE (2009) is to promote and prevent poor health nationally involving the public, health professionals and patients in the process (NICE 2009).

It synthesizes the results of various primary studies by using strategies that reduces biases and random errors. These reviews follow a strict scientific design and provide consistent estimates about the effects of interventions, therefore, conclusions are defensible. Systematic reviews shows where knowledge is lacking and can be used to guide future research. These reviews are usually carried out in the areas of clinical tests such as diagnostic, screening and prognostic; public health interventions; economic evaluations; adverse effects and how and why interventions work. Cochrane reviews are systematic reviews undertaken by Cochrane Collaboration members, aims to help people to make well-informed decisions about healthcare by preparing, maintaining, and promoting the accessibility of systematic reviews of the effects of healthcare

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

The lesson and case studies presented for evaluation was a great learning exercise. A better understanding of how to interpret data was gained. Also, weighing the clinical significance versus the statistical significance to show relevance is invaluable. All research is not quality research and one must be equipped to recognize bias, threats to validity and proper population representation. Moreover, critiquing the credibility of a study is essential to the health care advances.

The topic in this systematic review is clearly defined in the abstract & the introduction. Yes, the search for studies and other evidence was comprehensive and unbiased as it was able to be. Strict criteria were followed as described in Figure 1.

Both clinicians who are enquiring clinical questions and researchers who are conducting in-depth searches for systematic reviews come across a few

CEBM 2011 levels of evidence, this study falls under Level 4 since the evidence was from a

A total of 4219 studies were identified. After removal of duplicates and after exclusion criteria were applied, there were 13 studies to be included. All 13 were case series with controls.

Evaluating the eight papers for quality evidence was critical when selecting the two papers to utilise. The evidence hierarchy was considered, aiming to use the highest evidence possible, such as systematic reviews and meta-analyses; and randomized, controlled, double-blind studies, to ensure the most accurate evidence informed the clinical decision for the patient (Bloom, Olinzock, Radjenoic & Trice, 2013). When sorting the results, other various factors were also taken into consideration; credibility, reputability, reasonability and support. With these factors taken into account, the two papers selected are highly esteemed in regards to evidence, and are most relevant to the patient (Stichler, 2010).

The first section in the methods section describes the protocol to be followed. In order to find appropriate studies for the meta-analysis, Taylor and Swerdfeger, examined articles from Medline, Pubmed, Embase, and Google Scholar using the guidelines outlined by the Preferred Reporting Items for Systematic Review and Analysis (PRISMA) and independently assessed the risk of bias using the Newcastle-Ottawa Scale (NOS). Eslick then reviewed the articles. Following this, Taylor manually extracted the study design, the country of completion, sample sizes, interventions, outcome measures, and measures of effect from the articles. All literature had to be published and there was no language restriction on the studies,

The topic in this systematic review is clearly defined, initially in the abstract, and being repeated in the introduction. Yes, the search for studies and other evidence was comprehensive and unbiased as it was able to be. Strict criteria were followed as described in Figure 1. Yes, the screening of citations for inclusion in this review was based on explicit criteria, as they wanted to promote confidence in the outcomes appropriate guidelines were followed carefully. Yes, the included studies were evaluated for

One might query the nature of the method used to collect and conduct the study due to the fact that it is a systematic review and meta-synthesis as a counterpart. LoBiondo-Wood & Haber emphasized, “a researcher who uses any of the systematic review methods of combining evidence does not conduct the original research or analysis, but rather takes the data from already published studies” (p. 229). This method was presented clearly and understandable to the

Baldness is a common occurrence among men. It is typically regarded as something normal and not indicative of any kind of health condition, although it may cause psychological distress in the affected. However, scientists have discovered positive correlations between baldness and several pathologies. Male-pattern hair loss, as it is formally known in the medical realm, affects at least 50% of men in old age. Its causes are believed to be largely genetic. Recent studies have finally shed some light on the genetic underpinnings of the condition, revealing several complex relationships with other diseases and innate traits.

the studies should be critically appraised so that it will be included in the systematic review;